Treatments

HOW DOES IT WORK?

• At increased pressure, oxygen dissolves into the plasma of the blood, resulting in increased delivery of oxygen to the tissues.
• Increases white blood cell activity at the wood site, this boosts your body’s own immunity to fight the infection in the wound.
• Reduces oedema (swelling) by vasoconstriction (blood vessels constrict)
  Granulation (growth of new blood vessels) and angiogenesis (growth of nerve endings) occur in the damaged areas of the body
• Alters pressure gradients in wound edges, encouraging the wound to heal and get smaller.
• Production and mobilization of human Stem Cell’s @ 1.9 ATA and more (< 9 meters of seawater)

THERE ARE TWO TYPES OF HYPERBARIC OXYGEN CHAMBERS:

• Monoplace: Accommodates one patient at a time (used at Milpark Hyperbaric Medicine Centre)
• Multiplace: May accommodate between 2-10 patients at a time, consisting usually of patients and a chamber supervisor (who may be a doctor, a nurse, or other medically trained staff operator).

CONDITIONS APPROVED BY AND ACCEPTED INTERNATIONALLY BY THE UNDERSEA AND HYPERBARIC MEDICAL SOCIETY:

• Air or Gas Embolism
• Carbon monoxide and cyanide poisoning
• Compartment syndrome or Acute peripheral ischemia (e.g. Crush injuries)
• Compromised Skin flaps or Grafts
• Decompression Illness (‘The Bends’)
• Exceptional blood loss anaemia (in people who cannot receive blood transfusions due to religious reasons such as Jehovah’s Witnesses, or those that cannot be cross matched in time)
• Gas gangrene (Clostridial myositis or myonecrosis) – Should be treated as soon as possible
• Necrotising soft tissue infections (such as necrotising fasciitis/ flesh eating disease)
• Problem wounds (diabetic ulcers, venous stasis ulcers, decubitus ulcers, etc.)
• Radiation necrosis (osteonecrosis, proctitis, etc.)
• Refractory osteomyelitis (Chronic bone infections)
• Thermal burns (hands and face/difficult to graft areas)
• Intracranial abscess
• Idiopathic Sensorineual Sudden Hearing Loss
• Retinal Artery Occlusion

PREPARATION FOR TREATMENT:

• Patients are referred to the unit by a medical practitioner or may self-refer.
• Patients are assessed by a hyperbaric physician who will recommend a treatment plan and establish whether there are any contra-indications.
• The hyperbaric staff liaise with the medical aid (where applicable) to obtain pre-authorisation for chronic treatments, but it remains the patient’s responsibility.
• In the event of an acute emergency, no pre-authorisation is required.

HOW WILL THE TREATMENT FEEL?

• When being taken down to pressure, it may feel quite warm and be a bit noisy.
• During compression, you will feel the need to equalise your ears intermittently to adjust to the changes in pressure.
• Once the treatment depth has been reached, you will not feel any different and you will be encouraged to relax by watching TV or listening to the radio or just sleep.

ARE THERE ANY SIDE EFFECTS?

The most common are barotraumas which affect the following body spaces:

• Sinus cavities (if you are suffering from congestion)
• Ears
• Teeth (infected or restored teeth that may have gas contained inside)
• Gastro-Intestinal Tract
• Oxygen toxicity (which very rarely occurs) – symptoms include:
• Dizziness or Vertigo
• Tinnitus (ringing in the ears)
• “Spots” appearing in your vision
• Nausea or vomiting
• Trembling or shaking in the extremities
• Tingling sensation in fingers or toes and occasionally around the mouth
• Seizures (which are extremely rare & do not have a permanent effect on the patient)

HOW DOES HYPERBARIC OXYGEN THERAPY WORK?

• At increased pressure, oxygen dissolves into the plasma of the blood, resulting in increased oxygenation and increased white cell activity at the wound site, which boosts the body’s immune system to fight infection in the wound and promotes healing.
• Reduces swelling (oedema) by vasoconstriction of the blood vessels
• Alters pressure gradients in wound edges, promoting wound healing by increased deposition of matrix structure

WHAT ARE THE ACCEPTED INDICATIONS TO TREAT WITH HYPERBARIC TREATMENT?

• Air or gas embolism (blood vessel blockage caused by one or more bubbles of air or other gas)
• Carbon monoxide and cyanide poisoning
• Compartment syndrome or acute peripheral ischemia (crush injuries)
• Compromised skin flaps or grafts
• Decompression sickness (“The Bends”)
• Exceptional blood loss anaemia (in patients who cannot receive blood transfusions due to religious reasons, or those that cannot be cross matched in time)
• Gas gangrene (life threatening and should be treated within an hour after diagnosis)
• Necrotizing soft tissue infections (necrotizing fasciitis)
• Problem wounds (including diabetic ulcers, venous stasis ulcers)
• Radiation necrosis
• Refractory osteomyelitis (chronic infection in bone)
• Retinal artery occlusion
• Intracranial abscess
• Sudden Hearing Loss
• Research is currently being conducted on acute head injuries, sports injuries, strokes and near drownings

ABSOLUTE OR RELATIVE CONTRA-INDICATIONS

• Untreated pneumothorax or history of spontaneous pneumothorax (the abnormal presence of air between the lung and the wall of the chest (pleural cavity), resulting in the collapse of the lung)
• Certain medications
• Pregnancy (unless the benefit is greater than the risk)
• Claustrophobia (if severe, patients may be given medication)
• Upper respiratory infection (such as congestion, influenza, sinusitis, or colds)
• Hyperthermia

WHAT IS A TRANSCUTANEOUS OXIMETRY MEASUREMENT (TCOM) TEST?

• It is an assessment tool used to predict non-response to treatment by assessing the patient’s vascular system
• Historically used to monitor oxygen uptake in neonates.
• Used as a tool to select candidates for hyperbaric oxygen treatment by identifying the presence of tissue hypoxia and responders to hyperoxia
• Assists in determining when treatment benefits have been achieved
• Cost saving and non-invasive
• Milpark Hyperbaric Medicine Centre is the only facility in the Greater Gauteng area with a TCOM machine on standby 24/7

DOES SMOKING AFFECT MY TREATMENT?

It is important to stop smoking during the treatment schedule as this reduces the amount of oxygen delivered to the tissues

WHAT DO THE STAFF AND PHYSICIANS NEED TO KNOW BEFORE COMMENCING HYPERBARIC OXYGEN THERAPY?

• If you experience cold or flu symptoms, or if there is sinus, nasal or chest congestion
• A possibility of pregnancy
• If you have skipped a meal prior to treatment (hyperbaric treatment may lower your blood sugar levels)
• If you are diabetic
• History of lung trauma
• Medication being used
• If you have any concerns